RT Journal Article
SR Electronic
T1 Lesson of the month 1: Broken heart in the intensive care unit
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 447
OP 448
DO 10.7861/clinmedicine.14-4-447
VO 14
IS 4
A1 Rahman Shah
A1 Michela R Shelton
A1 Kodangudi B Ramanathan
YR 2014
UL http://www.rcpjournals.org/content/14/4/447.abstract
AB Takotsubo cardiomyopathy (TCM) is an unusual form of acute cardiomyopathy showing left ventricular apical ballooning. TCM can masquerade as ST elevation myocardial infarction (STEMI). TCM usually occurs following a variety of emotional stressors, but physical stressors can also trigger the condition, as highlighted by the present case. TCM can occur after an acute medical illness; therefore, physicians should be aware of this condition as a potential cause of inotrope-resistant hypotension. In patients with hypotension and moderate-to-severe left ventricular outflow tract (LVOT) obstruction, inotropic agents should be avoided, because they can worsen the degree of obstruction. Instead, beta-blockers are preferred, because they are capable of resolving the obstruction and consequently improve the haemodynamics.